A breast cancer diagnosis may cast a darker shadow for black women than it does for whites, from beginning to end.
Racial differences in breast cancer survival increase according to the stage of the disease, according to researchers from Columbia University Medical Center and the Mailman School of Public Health in New York. These differences are most apparent in advanced stages of the disease. The key finding within this study is, stage for stage, black women have worse clinical outcomes than white women.
After adjusting for tumor size and lymph node status, and other known risk factors, like age, mortality rates for black women were as much as 56-percent higher than for whites.
Authors of the study said whether these differences are due to a difference between races in tumor biology or to socioeconomic factors that impact healthcare access and/or the physician-patient relationship continues to be unclear.”We find, if you look at treatment, that blacks do get poorer quality treatment than whites do,” co-author Alfred Neugut, M.D., Ph.D., medical oncologist and epidemiologist told Ivanhoe. “Not necessarily poor quality in that it is being denied to them, but some of the other reasons we’ve found. For example, one of my colleagues, Dawn Hershman, found blacks tend not to finish their treatment even if they start the correct treatment. If you don’t finish the correct treatment, you don’t do as well.”
Dr. Neugut said doctors need to find ways to encourage all women to get the support they need so they are more able and willing to finish their treatments. Dr. Neugut also said these racial survival disparities hold true beyond breast cancer; colon cancer is one of several other cancers in which blacks have been shown to have reduced survival rates compared to whites.
Dr. Neugut sited evidence from studies showing the statistical disparities were identical for blacks and whites until the mid 1980s. After that point, the survival rates began to separate. “To me, that strongly implies that it’s really treatment issues — access to or use of treatment — that became different between the two. So, we really need to make sure that we get the same treatment to everybody,” Dr. Neugut said.
SOURCE: Ivanhoe interview with Alfred Neugut, M.D., Ph.D.; CANCER, published online Aug.13, 2007
